Gastroenterology and Hepatology

Frequently Asked Questions (FAQs)

What is a gastroenterologist?
A gastroenterologist is a highly trained physician who has specialized in the diagnosis and treatment of gastrointestinal diseases and conditions ranging from Crohn's to inflammatory bowel disease, from esophageal disorders to stomach ailments, and from hepatitis or other diseases of the liver / biliary tract to pancreatic diseases.  A GI physician performs procedures using endoscopes—flexible tubes that when inserted in the digestive tract allow for inspection, biopsy and therapeutic interventions.  Endoscopy may permit the detection of certain cancers, polyps or ulcers, or it may be used to determine the cause of bleeding in the digestive tract.  Advanced endoscopic procedures, like those performed at the University of Rochester Medical Center, may be used to diagnose and treat conditions of the liver, gallbladder or pancreas.
What is a screening colonoscopy?
All adults should undergo colon cancer screening beginning at age 50 or earlier, depending upon the risk of developing colorectal cancer. Several tests are currently available, each of which has advantages and disadvantages. The optimal screening test is a screening colonoscopy. A screening colonoscopy is a commonly ordered health screening examination of the colon. The patient is given a mild sedative drug before the procedure. During a colonoscopy, a thin lighted tube is inserted through the rectum allowing the gastroenterologist  a full view of the lining of the rectum and the entire colon.  If polyps are discovered, they may be removed as part of the procedure.
What is a polyp? Are they normal?
Polyps are considered to be an abnormal growth in the lining of the digestive tract.  They are usually benign, but vary in size and structure. Cancer may begin in polyps, so their removal is necessary to allow pathologists to determine their specific risk.
Will I be uncomfortable during my procedure?
During an endoscopic procedure, the patient is consciously sedated using a combination of drugs.  An anesthesiologist is not necessary for routine colonoscopies or EGDs (upper GI endoscopies).  The patient may or may not be awake during the course of the procedure, and frequently upon recovery the patient has no memory of what happened during their procedure.  Common sensations are bloating, pressure and cramping as the colon is expanded with air as the endoscope is passed through the colon.
One of my parents had colon cancer.  Am I at risk?
Your primary care physician may want to reduce any risk of cancer by ordering a baseline colonoscopy before the age of 50. This procedure is identical to a screening or routine colonoscopy in that the inner lining of the colon is examined and any polyps are biopsied and may be removed.  Specific risk due to familial circumstances should be discussed at length with your primary care physician.
My doctor is treating me for GERD?  Will I need an upper GI endoscopy?
GERD, gastroesophageal reflux disease, is caused when stomach acid travels back up into the esophagus.  The symptoms of GERD are frequent heartburn, difficulty swallowing, regurgitation of food and fluids, chest pain and asthma.  Normally, there is a valve (LES) at the lower portion of your esophagus that opens when you swallow but remains closed at all other times.   This valve usually prevents reflux.  Malfunction of this valve causes reflux.  GERD may be controlled with lifestyle and diet changes.  Not all heartburn is GERD, but longstanding heartburn, especially if uncontrolled with over the counter medications, weight control and lifestyle changes, may require evaluation by gastroenterologist.
What kind of preparation is necessary for an endoscopy?
The preparation varies depending on your health history and the procedure planned.  For endoscopic examination of the upper digestive tract, food and fluids are withheld for several hours before the procedure.  For endoscopic examinations of the colon, a special diet needs to be followed for several days in addition to the need for a thorough bowel prep to cleanse your colon prior to the procedure.  There may be variations to these preparations, depending on your condition. It is very important to follow your instructions carefully, as an incomplete preparation may require an additional appointment. Please consult the endoscopist's office if you have any questions about your preparation.  A full preparation is necessary, as a partial prep will likely result in an additional appointment.
What are the risks associated with undergoing an endoscopic procedure?
Endoscopies are generally safe when performed by physicians with specialized training and experience.  In rare circumstances, a perforation of the digestive tract may occur, which would require surgery to repair.  Minor bleeding may occur at the site of a polypectomy, but this typically stops on its own or may be controlled by the endoscopist.  There could be adverse reaction to the sedatives given for the procedure, but this too is rare.
Severe abdominal pain, fever or rectal bleeding should be reported to the endoscopist during the post-procedure recovery period, or if they are experienced within a couple days following an endoscopic procedure.

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