Gastroenterology, while a widely recognized medical specialty, is often misunderstood. Dr. Benjamin Levy III, a gastroenterologist at the University of Chicago Medicine, addressed some of the most common misconceptions in a discussion with Becker’s:
- Purpose of Gastroenterology: Many perceive gastroenterology primarily as a diagnostic specialty, particularly for identifying polyps and colon cancers through colonoscopies. However, a significant aspect of the field is the prevention of colon cancer by removing polyps before they can develop into cancer. Additionally, gastroenterologists play a role in preventing esophageal cancer by treating dysplasia in patients with Barrett’s esophagus resulting from chronic GERD/reflux.
- Scope of Gastroenterology: Contrary to the belief that gastroenterologists only focus on the stomach and colon, they actually treat the entire digestive system. This includes the liver, gallbladder, pancreas, stomach, small bowel, and colon. They manage conditions like hepatitis, cirrhosis, and pancreatitis and can perform procedures like endoscopic retrograde cholangiopancreatography to remove bile duct stones.
- Endoscopy: The term “endoscopy” is often associated only with esophagogastroduodenoscopy (EGD) or upper scope procedures. However, it’s a general term for procedures where a flexible tube with a camera is used to examine the gastrointestinal tract.
- Colonoscopy Experience: Many patients fear that colonoscopies will be painful. In reality, patients are carefully sedated, often with the help of anesthesiologists using propofol, ensuring they are comfortable and mostly unaware during the procedure.
- Colon Cancer Screening: While colonoscopies are effective for screening colon cancer due to the ability to remove polyps, they aren’t the only method. Some patients, especially those with other severe illnesses, might opt for stool-based tests like FIT (fecal immunochemical testing) or Cologuard. However, a positive result from these tests would necessitate a follow-up diagnostic colonoscopy.
In conclusion, gastroenterology is a multifaceted specialty that goes beyond mere diagnostics, playing a crucial role in the prevention of various cancers and the treatment of a wide range of digestive conditions.