In following list of German physicians you will find the best gastroenterology surgeons. Here you can access the presentations of these experts and send them a direct request for trearment or estimated cost.
As a branch of internal medicine, gastroenterology is concerned with diseases of the gastrointestinal tract, the liver and the digestive tract hormone glands such as the pancreas. Gastroenterologists are studying how gastrointestinal disease develops and how common it is. In addition, they diagnose and treat these conditions and advise patients on how to protect themselves from them.
An important area of responsibility is the diagnosis and treatment of tumors of the gastrointestinal tract. Other common diseases are:
- Diseases of the esophagus and stomach
- Jaundice (hepatitis)
- Chronic inflammatory bowel disease, eg. Ulcerative colitis
Important examination methods for the gastroenterologist are z. As the ultrasound examination of the abdominal cavity, the so-called endoscopy including endoscopic ultrasonography and other imaging techniques. This allows him to examine and treat diseases of the digestive system without surgery.
Various therapeutic approaches are available to the gastroenterologist. So he can treat chronic liver disease with drugs and remove growths of the intestinal wall (polyps) during a colonoscopy. Also bile duct stones can be removed and narrowed bile ducts can be extended. Gastroenterologists work with surgeons, radiologists and oncologists to treat gastrointestinal diseases.
The gastrointestinal tract is the main part of our digestive system. Phrases such as "something beats me on the stomach" or "love goes through the stomach" reveal much about its great importance. How important our digestive organs are to general wellbeing often becomes clear to us only when they no longer function properly. That is why you should treat them carefully, because a conscious lifestyle can contribute much to a healthy stomach and intestine.
German physicians enjoy a high reputation and trust in Germany. If you need a gastroenterological operation, send an inquiry today!
During the gastroenterological diagnostics in Germany following test methods can be used, depending on patient's indications:
- modern laboratory test methods including immunoassays;
- functional tests;
- endoscopic methods of diagnostics including capsule endoscopy;
- ultrasound examination;
- X-ray examinations can also be utilized as additional methods if necessary;
- magnetic resonance imaging and computed tomography, radiography, etc.
Nowadays capsule endoscopy is one of the most advanced methods that is used in gastroenterological diagnostics in Germany. With its help a specialist is able to examine in details the whole digestive tract, including the parts of the small intestine that are not accessible for other examination methods. In the course of the diagnostic the patient swallows a miniature camera which is surely protected by a capsule. The number of images per second can be adjusted depending on the movement speed of the camera inside the gastrointestinal tract.
The capsule endoscopy procedure should be used in the stomach megalgias of an unknown origin, long lasting anaemia, Crohn's disease, and pathologies of the small intestine that are characterized by malabsorption. Additionally using the capsule endoscopy it is possible to detect hidden bleedings, tumoral neoformations, parasitic and inflammatory diseases.
With endoscopy, body cavities and hollow organs can be viewed. For this, the internist pushes a flexible rubber tube or a thin metal tube, the so-called endoscope, into an artificially created or naturally existing body opening.
The areas of the small intestine that are inaccessible to conventional endoscopes can be examined by the doctor with a further development of endoscopy, the so-called capsule endoscopy. The patient chooses to swallow a capsule with a camera. Through the intestinal activity, the capsule migrates through the entire intestine and takes pictures at regular intervals.
Another new endoscopic examination method of the small intestine is the double balloon endoscopy, which can be used primarily to clarify unclear bleeding or for the detection of rare small intestinal tumors.
The thoracic cavity (thoracoscopy, mediastinoscopy), the large airways up to the bronchi (bronchoscopy), the gastrointestinal tract (gastro-, colo-, recto-, proctoscopy) and the abdominal cavity (laparoscopy) can be examined endoscopically. In addition, some joints can be examined in this way (arthroscopy). Endoscopy is sometimes combined with other medical methods, such. B. with surgical procedures for tissue sampling (biopsy) or with an X-ray examination.
An endoscopic examination performed on natural orifices such as the mouth or anus is usually painless, but is sometimes considered uncomfortable. Patients are therefore locally anesthetized and additionally receive a tranquilizer
With a new procedure, the so-called narrow-band imaging, the gastroenterologist can examine the fine structure of the mucosa of the gastrointestinal tract without staining. He also recognizes early forms of cancer, even at a size of a few millimeters. In combination with ultrasound (endoscopic ultrasound) he can even determine how deep in the intestinal wall altered cells are present.
The risk of endoscopy is that tissue is irritated or damaged by the endoscopic examination. Thus, after endoscopy, the occurrence of weak and in most cases harmless bleeding is possible. Mostly, the doctor can still breastfeed with the help of the endoscope during the procedure. In addition, pathogens can enter the body through endoscopic examination. In order to avoid infections, antibiotics are therefore sometimes prescribed as a precautionary measure.
Particularly important is an embarrassing compliance with the hygiene regulations for cleaning and reprocessing the endoscopes and the accessories. The cleaning is done today usually with high quality semi or fully automatic washing machines. Bacteriological controls of the devices are mandatory every six months. In addition, corresponding certificates are issued.
Overall, however, endoscopy is a very gentle and safe examination. The advantage of the method is that it provides very accurate examination results and can often replace more complex procedures.
An esophagogastroduodenoscopy - gastroscopy or gastroscopy for short - is the examination of the upper part of the digestive tract (esophagus, stomach and duodenum) with the help of an endoscope. This consists of a flexible tube through which the doctor can see the inside of the digestive tract using special video optics.
Today's endoscopes produce a high-resolution, digital image on a video monitor. Instruments can also be inserted through a small channel inside the tube and, for example, tissue samples (biopsies) can be taken or bleeding can be stopped. With a small ultrasound device at the tip of a special endoscope, the layers of the stomach or intestinal wall can be assessed (endosonography).
When is a gastroscopy necessary?
The most common reasons for gastroscopy are:
- Difficulties swallowing,
- Upper abdominal pain,
Heartburn occurs when the esophageal lining is irritated or inflamed by acidic gastric juice (reflux disease). The most common causes of upper abdominal pain are inflammation (gastritis, duodenitis) and ulcers in the stomach and duodenum (ulcer). Bleeding occurs due to inflammation, ulcers or tumors, but also due to the bursting of varicose veins in the esophagus (esophageal variceal bleeding in cirrhosis of the liver). If you bleed heavily, you will vomit blood or your stool will turn black.
Note: A preventive examination similar to a colonoscopy is currently not generally recommended. In this indication, gastroscopy should be performed in certain groups at risk, such as people with a family history of gastric cancer. Repeated or existing upper abdominal complaints and also heartburn should definitely be the reason for a gastroscopy.
What preparations are required?
The esophagus, stomach, and duodenum are hollow organs through which food is ingested and digested. In order to be able to optimally assess the wall of these hollow organs, the patient has to stay empty for about six hours before the examination, that is, do not consume any food or drinks. Clear drinks can be taken up to two hours before the examination (to be on the safe side, always discuss this with the treating doctor). Removable dentures must be removed before the examination in order not to damage them or to prevent them from being swallowed.
Blood-thinning drugs (e.g.Marcoumar, Sintrom) do not have to be discontinued before the examination. If a sample is taken (biopsy), the risk of bleeding from the mucous membrane is only minimally increased. However, if major interventions such as the endoscopic removal of precursors or early forms of esophageal and stomach cancer are planned, it is advisable to stop taking blood-thinning medication. In individual cases, the risk of bleeding must be weighed against that of a cardiovascular event by discontinuing the medication. Consultation with a doctor is recommended.
Many hospitals nowadays offer an examination under intravenous administration of a sedative (sedation) or a short anesthetic. As a result, this examination, which is often perceived as uncomfortable, is easier for patients to tolerate. You will receive information about this possibility of relief from your treating doctor. In contrast to general anesthesia, sedation only causes a reduction in anxiety, reassurance, reduced memory and sometimes sleep. During the entire examination, the circulation is monitored by means of a pulse oximeter. Since the ability to react may be impaired for a few hours after the examination, driving a vehicle after sedation is prohibited.
How is the examination performed?
The examination is carried out in the supine or lateral position. The doctor inserts the endoscope through the patient's mouth into the esophagus and pushes it up to the duodenum. There is a lubricant on the rubber hose. A hard teether in the mouth is designed to prevent the tube from being bitten. The introduction of the endoscope requires active "swallowing" on the part of the patient at the beginning, which is also possible under the influence of an anesthetic.
The entire wall of the esophagus, stomach and duodenum is examined through the video optics. Instruments can be inserted through a channel in the endoscope. For example, special forceps can be used to take tissue samples (biopsy) or to remove growths using a metal loop. In addition, bleeding from a mucosal vessel can also be stopped in this way. This is done either using small metal clips or an injection of hemostatic medication. In addition, narrowing of the esophagus can be expanded and stents (small metal mesh) can be applied. These are inserted on an insertion catheter and released under X-ray control. Other interventions include, for example, the removal of precursors or early forms of esophageal and stomach cancer.
What side effects / complications can occur?
Many patients find the examination uncomfortable because of the "swallowing" of the endoscope. However, gastroscopy is not painful.
The following complications can occur during gastroscopy:
- Damage to the dentition with loose teeth or prostheses,
- Bleeding after sampling (biopsy) or other interventions (e.g. stent),
- Rarely injury to the esophagus-gastrointestinal wall through the endoscope,
- Very rarely infections.
In the case of severe complications, such as injury to the gastrointestinal wall (perforation), which can occur especially in the case of an inflamed wall or tumors and ulcers, or in the case of heavy bleeding, an operation under general anesthesia and the administration of blood products may be necessary.
Where is a gastroscopy performed?
A gastroscopy can be performed by specialists in internal medicine or surgery as well as in hospitals with departments for internal medicine / gastroenterology or surgery. A medical referral is required.
- Specialists in internal medicine or surgery
- Hospitals (with departments for internal medicine / gastroenterology or surgery)
Colonoscopy is one of the most informative methods of gastroenterological diagnostics of the colon. Timely performed procedure makes it possible to detect a disease in the organ at an early stage, including cancer that progresses without evident clinical manifestations. Another reason to perform a colonoscopy are bleedings and pains of unknown origin, polyps of the colon. During the procedure a biopsy can also be performed.
Solid organs such as pancreas and liver are also parts of the digestive tract. Diagnostic sonography plays a particularly important role in their examination which can also be performed using contrast agent.
One of the innovative methods of gastroenterological diagnostics is the so called endoscopic ultrasound that implies the use of an endoscope equipped with an ultrasonic sensor. During the examination the doctor receives precise data about the pancreas, bile duct and has an opportunity to get the material for laboratory study. Additionally, using the endoscopic ultrasound the gastroenterological diagnostics of esophagus, stomach, and rectum can be carried out.
New opportunities of gastroenterological diagnostics in Germany
To perform an effective treatment the most sparing and effective methods are used:
- scaled endoscopy;
- inner and distant lithotripsy;
- different methods of resection of mucous membrane and neoplasms in different parts of the gastrointestinal tract;
- interventional removal of stones in pancreas and bile ducts;
- stenting and dilation, etc.
Gastroenterological diagnostics in Germany makes it possible to detect the most serious diseases of the gastrointestinal tract on the early stages, to develop optimal treatment tactics and to provide an adequate aftercare for the patient. The experience of specialists of the Culminasceum clinic makes it possible to cope with the most difficult cases in cooperation with surgery, radiology and other departments of the clinic.