What are gastroenterologists?
Dr. Tan Chi Chiu explains the expertise involved in the diagnosis and management of diseases of the digestive system
A gastroenterologist is a specialist doctor who has special interest and expertise in the diagnosis and management of diseases of the digestive system, says Dr. Tan. The digestive system involves several parts; it starts at the oesophagus and goes down into the stomach and then into the small intestine and after masses of small intestines it goes into the large intestine, which is also called the colon, and then the exit point, which we call the other end.
Associated with these organs are the other organs of digestion, for example the liver, the gall bladder and the pancreas. Now a gastroenterologist is a specialist who has first been trained in internal medicine. This means that we have to have a wide and deep knowledge of all bodily systems and their physiology as well as what can go wrong and how to treat the various systems, and only then do we sub-specialize in gastroenterology.
This is important because even though we are specialists in one system it does not exist in isolation from the rest of the body. It is very important to treat patients holistically and to understand that diseases or malfunctions of different organ systems can impact the digestive system and vice versa as well.
Most gastroenterologists are also hepatologists, which is a term that means ‘a specialist of liver diseases’. Most gastroenterologists are also hepatologists because the liver is an organ associated with the digestive system. But because the liver is so complex and is subject to many different influences and many possible diseases, some gastroenterologists take a very special interest in the liver.
A gastroenterologist at the same time is also an expert endoscopist. Endoscopy in the digestive tract is the ability of the gastroenterologist to look into the digestive tract using high technology flexible tubular instruments [called endoscopes] with cameras and lights and the ability to pass surgical instruments through to either biopsy tissues or to conduct some therapeutic procedure.
Endoscopy is a skill, which has been learned over many years. Gastroenterologists specialize in endoscopy, and in fact, do no other procedures. So our entire focus in terms of our practical procedures is on endoscopy. In general, gastroenterologists have invented most endoscopic procedures. The interpretation of the pictures and the various methods by which tissues are diagnosed is also something that has been mainly developed by gastroenterologists. Gastroenterologists as a group are highly specialized in endoscopy and how we use it to diagnose and treat digestive conditions.