This is the first of a two part series in which we're discussing the underlying differences between Gastroenterologists and IBS Experts. The differences are significant and a deeper understanding of the various approaches to your health will help you to make more informed decisions about your own.
Part 1 - Gastroenterology
People often make assumptions about medical specialists and their areas of expertise. This is certainly true with gastroenterology, where many people assume that gastroenterologists are experts in all things related to the digestive tract.
Gastroenterologists are experts in diseases of the digestive tract, not syndromes or symptoms. While Gastroenterologists do primarily pay attention to the digestive tract, there are some surprising gaps in their training on the science of digestion. Gastroenterologists primarily focus on performing colonoscopies and upper endoscopies. They may also do other imaging work of the GI tract, such as an ultrasound, CT scan,MRI, x-rays, and even “pill cameras”. And they may perform studies that assess the motility of the digestive tract. Therefore, if you go to a gastroenterologist your diagnosis will be based on this testing.
Notice that all of the things mentioned so far are visual exams. Gastroenterology is primarily a specialty in assessing the structure of the digestive tract. Gastroenterologists are focused on diagnosing ulcers, polyps, cancers, and other physically apparent abnormalities of the digestive tract.
A gastroenterologist may run a stool test for pathogens such as giardia, salmonella, and hemorrhagic E. coli, although any doctor can test for these. However, H. pylori may be assessed via a biopsy done during an endoscopy.
Surprisingly, gastroenterologists do not have training in nutrition or most reactions to foods. And though the digestive tract is the single most concentrated area of immune activity, gastroenterologists have no special training in immunology.
The tools of the gastroenterologist are all very useful tools – they are really important to diagnose cancers, structural problems, certain kinds of infections, and other problems. But the standard of care for problems other than those is purely palliative (also known as care to make you feel better about having IBS). The American College of Gastorenterology recommends (in their 2009 position paper) fiber, lowering stress, and a few drugs. This is where the specialties of gastroenterology and IBS diverge.
Article Courtesy: Dr. Stephen Wangen
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