Gastroenterology (‘gastro’ meaning ‘stomach’, ‘entero’ meaning ‘intestine’) is a field of medicine that deals specifically with the gastrointestinal tract (i.e., mouth to anus), the liver, the biliary tree, and the pancreas.
What is the need for a separate branch of study?
Until the late 20th century, gastroenterology was not a separate specialty and was studied and practiced as a part of medicine and a trained physician would cater to all the problems of the GIT. But as advances were made in imaging especially optics, we could see into the GIT using scopes. This enabled us to pursue greater detail and our knowledge of the same burgeoned. Eventually, scopes were not only used to ‘see’ but also to ‘treat’. Along with endoscopy, colonoscopy, endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, manometry, etc enhanced our capabilities to identify and treat. This expertise could be gained only through extensive training and study.
Advantages of having a separate branch
- Greater attention to detail- For example, if a patient comes with constipation i.e reduced frequency and hardened stools, all possible causes of constipation are investigated through history, and with the use of imaging; as opposed to if it were being handled by a general physician, fewer causes would be investigated (due to limitation in training).
- Personalization of treatment- Extensive training in specific organ systems i.e., gastroenterology provides more options for treatment of a specific disease/condition. Given the depth of knowledge that is attained through rigorous training, tailored made personalized medicine for all patients (considering their lifestyle, genetics, etc) ensures greater compliance and satisfying results
- Extensive understanding of disease- Given the specific nature of training, all GI diseases are studied in greater detail compared to general medicine. Therefore, comprehensive care can be established with a gastroenterologist by the virtue of the ‘master of one’ philosophy. Also, the interplay at the microscopic level to its macroscopic manifestation of GI diseases and the subsequent interplay with organ systems is best understood by a gastroenterologist.
- Evidence based medicine- The use of diagnostic modalities allows for ‘evidence or proof-based management of diseases. The expertise of all available diagnostic modalities is sought only through GI fellowship.