Gastroenterology

An Overview of Types, Diagnosis, and Treatment

Gastroenterology

An Overview of Types, Diagnosis, and Treatment

Diagnosing digestive issues requires precise tests like colonoscopy and endoscopy. Learn about gastroenterology diagnosis, preparation, and what results mean

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Gastroenterology - Diagnosis and Evaluation

Introduction

Diagnosing digestive issues requires precise tests like colonoscopy and endoscopy. Learn about gastroenterology diagnosis, preparation, and what results mean.

At LIV Hospital, we use the most advanced diagnostic tools available. From high-definition endoscopes to non-invasive imaging, our goal is to find the root cause of your symptoms quickly and comfortably. This section explains the common tests we use, how they are performed, and exactly how you should prepare for them to ensure the best possible results.

Common Screening Tests for Digestive Health

Screening tests are preventative exams done to find diseases before symptoms appear. In gastroenterology, the most critical screening is for colorectal cancer.

Routine tests include:

Colonoscopy: This is the “gold standard” for colon cancer screening. A flexible tube with a camera is used to examine the entire colon. It is unique because it can find and remove precancerous polyps during the same exam, preventing cancer from ever starting. It is recommended for everyone starting at age 45.
Stool Tests (FIT/FOBT): These are non-invasive tests that check your stool for hidden (occult) blood, which can be an early sign of cancer or polyps. While easier than a colonoscopy, they are less accurate and must be done every year.
Stool DNA Test: This test looks for genetic changes in the stool that suggest cancer. If positive, a follow-up colonoscopy is required.

Advanced Diagnostic Procedures

When screening reveals an issue, or if you have specific symptoms like chronic pain or bleeding, advanced diagnostic procedures are used. These allow direct visualization and treatment.

Upper Endoscopy (EGD)

An EGD examines the upper part of the GI tract. A thin scope is passed through the mouth to look at the esophagus, stomach, and duodenum (start of the small intestine). It is used to diagnose acid reflux damage (Barrett’s esophagus), ulcers, and Celiac disease.

Endoscopic Retrograde Cholangiopancreatography (ERCP)

This is a specialized procedure that combines endoscopy and X-rays. It is used to diagnose and treat problems in the bile ducts and pancreas, such as removing gallstones that are stuck in the main bile duct or placing stents to open blocked ducts.

Imaging Techniques

Sometimes, we need to see the “big picture” of the abdomen without going inside. Radiology plays a key role in gastroenterology diagnosis.

CT Enterography: A specialized CT scan that uses contrast dye to visualize the small intestine and check for inflammation, abscesses, or fistulas caused by Crohn’s disease.
Abdominal Ultrasound: A safe, radiation-free test often used as a first step to check for gallstones, liver disease, or ascites (fluid in the belly).
MRI / MRCP: Magnetic resonance imaging provides detailed views of soft tissues. MRCP is a specific type of MRI that visualizes the bile ducts and pancreatic ducts without needing an invasive scope.

What to Expect During a Colonoscopy

Many patients are nervous about colonoscopies, but understanding the steps can reduce anxiety. It is a routine and safe procedure.

The Step-by-Step Procedure:

Sedation: You will be given medication through an IV to make you sleepy and relaxed. Most patients fall asleep and wake up with no memory of the exam.
The Exam: The doctor inserts the colonoscope into the rectum and gently guides it to the start of the large intestine. Carbon dioxide is pumped in to inflate the colon for a better view.
Polyp Removal: If the doctor sees a polyp (a small growth), they use tiny tools passed through the scope to remove it immediately. This is painless.
Recovery: You will rest for about 30 to 60 minutes while the sedation wears off. You may feel some gas or bloating, which will pass quickly.

How to Prepare for Diagnostic Tests

Preparation is the most important part of a GI exam, especially for colonoscopy. If the bowel is not clean, the doctor cannot see the lining, and the test may need to be repeated.

Preparation Guidelines:

Diet Changes: usually, you must stop eating high-fiber foods (seeds, nuts, raw veggies) 3 to 5 days before the test.
The “Clear Liquid” Diet: The day before the exam, you cannot eat solid food. You can only have clear liquids like water, clear broth, black coffee, and apple juice. Avoid red or purple liquids, as they can look like blood during the exam.
Bowel Prep Solution: You will drink a strong liquid laxative the evening before and the morning of the procedure. This flushes out the colon completely. It will cause frequent diarrhea, so stay near a bathroom.
Medication Adjustments: You may need to pause blood thinners or diabetes medications. Always consult your doctor for specific instructions.
Fasting: For upper endoscopy (EGD), usually no bowel prep is needed, but you must not eat or drink anything for 8 hours before the test to keep the stomach empty.

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Understanding Your Test Results

After the procedure, your doctor will explain what they saw. If biopsies (tissue samples) were taken, final results usually take 3 to 5 days.

Common Findings:

Normal: The lining of the organ looks healthy, pink, and smooth. No growths or bleeding were found.
Polyps: The doctor will tell you how many were removed and their size. Pathology will confirm if they were precancerous (adenomas) or benign.
Inflammation (Colitis/Gastritis): Redness or swelling was seen. Biopsies will determine the cause, such as infection or autoimmune disease.
H. pylori: If tested for this stomach bacteria, a positive result means you will need a course of antibiotics to prevent ulcers.
Diverticulosis: The presence of small pockets in the colon wall. This is common and usually requires a high-fiber diet to manage.

When Do You Need Advanced Testing?

Not every stomach ache requires an endoscopy. Advanced tests are reserved for specific warning signs.

You typically need diagnostic testing if:

You are over 45 (for routine screening).
You have blood in your stool or black stool.
You have iron-deficiency anemia (low blood count) with no obvious cause.
You have trouble swallowing or food gets stuck.

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With patients from across the globe, we bring over three decades of medical expertise and hospitality to every individual who walks through our doors.

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FREQUENTLY ASKED QUESTIONS

What tests are used to diagnose acid reflux (GERD)?

Doctors often diagnose GERD based on symptoms alone. However, to confirm damage, an Upper Endoscopy (EGD) is used to look at the esophagus.

How do I prepare for a colonoscopy?

Preparation involves a clear liquid diet for one day before the exam and drinking a prescribed laxative solution to empty the bowel. You must also arrange for someone to drive you home, as you will be sedated and cannot drive for 24 hours.

Is an upper endoscopy (EGD) painful?

No, the procedure is not painful. You are given a sedative to help you relax or sleep. A numbing spray is also used on the throat to prevent gagging. Most patients do not remember the procedure and feel only a mild sore throat afterward.

How accurate are gastroenterology diagnostic tests?

Tests like colonoscopy and endoscopy are extremely accurate because they allow the doctor to see the tissue directly. A colonoscopy detects over 95% of large polyps and cancers. Biopsies taken during these procedures provide a definitive diagnosis for conditions like Celiac disease or cancer.

When do I need advanced imaging like an MRI or CT scan?

Advanced imaging is needed when the doctor suspects a problem outside the hollow digestive tract, such as in the liver, pancreas, or outer bowel wall.