Gastroenterology and hepatology

What is gastroenterology and hepatology? 

Gastroenterology deals with diseases of the gastrointestinal tract (oesophagus, stomach, intestines, colon and pancreas). Hepatology specialises in conditions affecting the liver, spleen and biliary system. 

Who can see a gastroenterologist or hepatologist?

Gastroenterologists specialise in treating patients with inflammatory and infectious diseases affecting the gastrointestinal tract as well as gastrointestinal cancers. Hepatologists treat a wide range of liver conditions.

What symptoms does a gastroenterologist or hepatologist treat? 

You should see a gastroenterologist if you are experiencing heartburn, constipation, diarrhoea, nausea, vomiting or weight loss. We recommend that you make an appointment with a hepatologist if you are experiencing fatigue, abdominal pain, abdominal swelling or yellowing of the skin. 

What are the potential treatment options in gastroenterology and hepatology?

Gastroenterology

●    Crohn’s disease

Crohn’s disease is a chronic inflammatory condition of the gastrointestinal tract and can cause abdominal pain, diarrhoea, tiredness and weight loss.
Anti-inflammatory drugs and immunosuppressant drugs, which work by suppressing the immune system, are used to calm the inflammation.

    Ulcerative colitis

Ulcerative colitis is a chronic inflammatory disease of the large intestine (colon and rectum) and can cause abdominal pain, rectal pain and the frequent need to empty the bowels.
Aminosalicylic acid derivatives are anti-inflammatory drugs and used to reduce inflammation in the lining of the colon and rectum. Corticosteroids help to reduce symptoms quickly.

    Food intolerances 

Food intolerances can cause abdominal pain, nausea and vomiting, diarrhoea, bloating, rashes and cold sweats. Gluten intolerance can cause coeliac disease which affects the small intestine. Lactose intolerance is the result of the body not producing enough of the digestive enzyme lactase.
A blood test will determine your immune profile, and an elimination diet removes the trigger foods in order to alleviate symptoms.

Hepatology

●    Hepatitis B and Hepatitis C

Hepatitis B and hepatitis C are inflammatory liver diseases that can become chronic.
The hepatitis B virus is transmitted through blood and unprotected sex. 
Interferons and antiviral drugs are used in treatment to increase the body’s immune response.
The hepatitis C virus is transmitted through blood. Direct-acting antiviral drugs can cure 95% of patients.

    Autoimmune liver diseases 

The immune system can attack the liver and cause inflammation. Symptoms can include tiredness, abdominal discomfort, yellowing of the skin and whites of the eyes, enlarged liver, dark urine, loss of appetite and pale stools. Corticosteroids and immunosuppressant drugs are effective at an early stage. However, a liver transplant is currently the only effective treatment.

●    Liver cancer

Cirrhosis, hepatitis B and hepatitis C can progress to liver cancer. Smoking and regular alcohol consumption also increase the risk of liver cancer. Ablation can be used to destroy the tumour if liver function is normal. However, if this is not possible, chemotherapy can slow the progression of the cancer. A liver transplant may be recommended if the liver has been damaged.

●    Cirrhosis

Cirrhosis is a chronic liver disease that can be caused by alcohol misuse or an infection. It requires regular follow-up in order to rule out complications. A liver transplant is currently the only effective treatment. 

●    NASH (non-alcoholic steatohepatitis)

NASH is a chronic liver disease and linked to a diet high in fat and sugar and a sedentary lifestyle. In some cases, NASH can progress to cirrhosis and cancer. Treatment involves lifestyle changes to reduce the fat in the liver.

Medical examinations

●    Gastroscopy and colonoscopy

A gastroscopy is used to look inside the stomach. A colonoscopy examines the large intestine and is used to screen for colon cancer and remove precancerous lesions.

●    Elastography

An elastography measures the stiffness of soft tissue and is used to diagnose liver diseases and tumours.

Care

A clinical examination is performed on an inpatient or outpatient basis in order to determine treatment and any further tests. We recommended that you see a gastroenterologist for regular check-ups if you have a family history of liver disease or chronic inflammatory conditions of the gastrointestinal tract.

Medical follow-up

An endoscopy performed under general anaesthetic requires a short stay in hospital. A colonoscopy can be performed on an outpatient basis without anaesthetic, which means you do not have to stay in hospital. Follow-up for a gastrointestinal or liver disease depends on the severity and progression of your condition.

Why see a gastroenterologist or hepatologist with Swiss Medical Network? 

Gastroenterologists benefit from the latest technology to treat liver diseases and chronic inflammatory conditions. For example, capsule endoscopy involves the patient swallowing a tiny capsule equipped with a camera and is used to view the whole of the gastrointestinal tract. 

FAQs

What happens during a gastroenterology appointment?

Before performing a physical examination and further tests, the gastroenterologist will review your history to diagnose your gastrointestinal or liver condition.

When should I see a gastroenterologist?

We recommend that you make an appointment to see a gastroenterologist if you are experiencing heartburn, chronic constipation, diarrhoea, bloating or abdominal pain.

When should I see a hepatologist?

You should see a hepatologist if your stomach is bloated and feels hard or if you are experiencing yellowing of the skin, nausea or vomiting.

What happens during an upper endoscopy?

This examination is performed on an empty stomach, under local or general anaesthetic, using an endoscope (a thin, flexible tube with a camera and light) to look inside your body. It is also used to take tissue samples, remove tumours or foreign bodies and stop blood vessels from bleeding.

Does an endoscopy hurt?

An endoscopy is a painless procedure performed under local or general anaesthetic.

Who should I see if I have a problem with my liver?

Hepatologists treat a wide range of liver conditions.

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