Ask the Gastroenterologist

By admin

Dr. Chris E. Forsmark graduated from Johns Hopkins University in 1983 with his medical degree and continued his studies at the University of California where completed an internship, residency and fellowship in internal medicine and gastroenterology. He is currently a Professor of Medicine and Chief of the division of gastroenterology, hepatology, and nutrition at the University of Florida.

What does a gastroenterologist do?
Gastroenterologists treat a wide variety of diseases and conditions affecting many different organs, including diseases of the esophagus, stomach, intestine, colon, liver, bile duct and gallbladder, and pancreas. They [gastroenterologists] treat both benign and malignant diseases such as gastroesophageal reflux (GERD), ulcers, hepatitis, pancreatic cancer, gallstones, colitis, Crohn’s disease, internal bleeding and gastrointestinal (GI) infections. Gastroenterologists see patients in clinics and in the hospital, and provide not only medical care but also endoscopic procedures.

These endoscopic procedures involve flexible scopes that examine the esophagus, stomach, colon, pancreas, gallbladder and bile duct. Endoscopic procedures are used for both diagnosis of diseases and treatment. For instance, a colonoscopy is used to look for colon polyps and remove them, which prevents colon cancer from developing from a polyp. In addition to providing medical care for patients, many gastroenterologists are involved in research.

When should people see a gastroenterologist?
Patients usually see a gastroenterologist for a symptom that suggests a gastrointestinal or liver problem. This might include abdominal pain, nausea, vomiting, difficulty swallowing, internal bleeding, jaundice, diarrhea, constipation or weight loss.

Can gastrointestinal problems be hereditary? If yes, how so?
Several diseases do run in families, including many gastrointestinal cancers. In addition, some benign conditions are seen more commonly in those with a family history, including ulcerative colitis and Crohn’s disease.

Can lifestyle changes impact GI health (i.e. food, smoking, drinking, etc.)? If yes, what kind of changes and what are the negative or positive impacts on GI health?
These environmental exposures have major impacts on GI health. Almost all GI and liver cancers are increased in smokers. In addition, excess alcohol can cause many GI conditions (pancreatitis and cirrhosis for example). High fat diets also worsen some GI diseases, particularly those associated with obesity. A diet high in fiber and low in simple carbohydrates and saturated fat is best.

Can gastrointestinal problems become severe and require hospitalization? If yes, what are signs and symptoms?
This occurs frequently. Most hospital admissions are for internal bleeding, severe abdominal pain, dehydration, intractable nausea and vomiting, jaundice or infections.

I experience frequent heartburn, is this normal? What should I do?
Heartburn is common. Reducing the fat in your diet, losing weight, exercise, and avoiding food prior to going to bed are effective treatments. If this does not work, it is worth discussing with your physician. In addition, if worrisome symptoms (trouble swallowing, vomiting, weight loss) are also present, an evaluation will be required.

I’m having bowel issues, should I see a gastroenterologist?
Diarrhea and constipation are common reasons someone would see a gastroenterologist. Before seeing a doctor, make sure you are on a high fiber diet, drink plenty of liquids, and get sufficient exercise as this is often enough to improve symptoms. Worrisome symptoms include blood in stool, a sudden change in stool, or weight loss.