introduction

The gastrointestinal tract comprises several organs, all of which serve to digest and absorb food. A disease of the gastrointestinal tract ( gastrointestinal tract ) is usually a disease of a single organ, but it can also be a disease of several organs. The gastrointestinal tract includes the esophagus, the stomach, the duodenum, the small intestine ( jejunum and ileum ), the large intestine (colon), the rectum ( rectum ) and the anus ( anus ).

Causes of gastrointestinal diseases

There are several causes that lead to a disease of the gastrointestinal tract. A distinction is made between diseases that can be treated with medication and do not require surgery (for example, flatulence, food intolerance) and diseases that require surgery (for example appendicitis or a tumor).

All diseases of the gastrointestinal tract that require surgery are summarized to the surgical gastrointestinal diseases. This area of ​​medicine is also referred to as gastroenterological surgery.

Starting at the esophagus, there are two medical conditions that require surgery:

  • First, there is the esophageal carcinoma. This is a malignant tumor in the esophagus, which is particularly common in patients of Asian origin.
  • Also, a so-called reflux oesophagitis may require a surgical procedure. This is an inflammation of the esophagus. This inflammation is caused by the very acidic and therefore harmful gastric acid which, in such patients, repeatedly passes into the esophagus due to a lack of occlusion, where it gradually damages the mucosa and thus inflames it. Reflux, ie the transgression of gastric acid into the esophagus, is promoted by fatty food, chocolate and increased coffee consumption.
  • The stomach can also cause problems that require surgery. These include, for example, gastric ulcers, which can be caused by excessive alcohol consumption. Such gastric ulcers should be recognized as soon as possible and surgically removed because otherwise gastric carcinomas, ie malignant gastric tumors can form, which then still can be removed surgically, but associated with an increased death rate.
  • In the area of ​​the stomach, however, narrowing can also be made. In critically ill diabetes mellitus patients, a narrowing of the stomach can be a huge step in the therapy to stem the disease again. However, gastric stenosis is mainly used in strongly obese people to reduce their weight as effectively and permanently as possible.
  • Even small or large intestine can be affected by diseases that require surgery. On the one hand there is a large class of inflammatory bowel diseases, for example Crohn's disease or ulcerative colitis. In addition, in this area of ​​the gastrointestinal tract carcinomas, so malignant tumors occur, which must be surgically removed so they do not scatter on other tissue.
  • Other causes of surgery may be bleeding or inflammatory diverticula. Diverticula are small protuberances of the intestine that do not cause problems in all cases. Frequently a human lives forever with " his " diverticulum without noticing. However, if it comes to complaints that accompany an inflammatory reaction, the diverticulum should be removed immediately. In this case one also speaks of an acute abdomen because the patient suffers from sudden very severe pain.
  • Reason for a surgical intervention may also be the rectum, so the rectum and the anus ( anus ). Here there are different pus-filled capsules ( abscesses ) or fistulas ( connections between two organs ), which usually require only a small intervention. Also, hemorrhoids are among the diseases of the gastrointestinal tract, although need a surgical intervention, but not significantly endanger the health. However, there are also malignant tumors in the rectal and anal area that require surgery.

diagnosis

To make a diagnosis, the doctor must first determine the location of the pain and the disease. First of all, he conducts a patient interview, the anamnesis. In this case, the patient can give information, for example, about the exact location and the intensity of the pain. The doctor will then palpate the patient. If necessary, in case of unclear diagnosis, blood may be taken to see if any inflammation parameters have risen or an ultrasound examination or a CT scan may be performed. In particularly unclear cases, it can also help when the patient takes contrast media to then find in the X-ray the exact cause of the gastrointestinal disease.

frequency distribution

Gastrointestinal diseases are among the most common diseases in Germany. Appendicitis alone is operated 127, 000 times a year in Germany. The probability of getting a diverticulum and getting sick increases in old age and is already around 30% among the 60-year-olds. Thus, diseases of the gastrointestinal tract are among the most popular diseases.

symptoms

Depending on which gastrointestinal disease is present, the symptoms can be very different:

  • Malignant tumors, no matter in which area of ​​the gastrointestinal tract, are usually noticeable very late because they cause no pain.
  • Reflux esophagitis usually manifests itself in pain after regurgitation, comparatively with heartburn.
  • A gastric ulcer or a gastric tumor are often noticed when the patient is tired of drinking alcohol or when he strongly refuses high-fat foods, especially meat. In addition, it often comes to nausea and vomiting.
  • Inflammatory small or large bowel diseases are usually caused by a changed stool, usually the change between diarrhea ( diarrhea ) and constipation ( constipation ) noticeable. In addition, there is sometimes severe pain in the abdomen ( abdomen ).
  • Also, a diverticulum makes itself felt in a similar way, the pain here being characterized by an acute abdomen, that is, they occur quickly and very intense.
  • Diseases in the rectum are quite common. Especially hemorrhoids affect more and more patients. Patients usually complain of an increasing itching around the anus.
  • The symptoms of an abscess are often nonspecific. However, because it is a purulent inflammation, it usually comes to fever and chills. With an externally visible abscess at the buttocks, the patient often has pain while sitting.
  • Even a fistula is usually associated with inflammation and can be difficult to diagnose under circumstances. However, if the fistula is in the anal canal, pain and leakage of blood and / or pus tend to occur and then creep into the underwear.

therapy

The diseases dealt with here usually require all a surgical intervention. Nevertheless, the drug treatment is very important.

All gastrointestinal disorders mentioned here require a surgical operation. In addition, however, it usually also requires a drug treatment:

  • In the case of a malignant tumor (carcinoma), it must be removed and, if necessary, chemotherapy thereafter.
  • In reflux oesophagitis, conservative therapy is sufficient in the early stages, but later a fundic sleeve is applied to the upper part of the stomach to prevent gastric acid reflux.
  • In the case of gastric ulcer, drug therapy is often sufficient at first, but in more severe cases the ulcer must be surgically removed.
  • With Crohn's Disease, the only treatment option may be surgical removal of the inflamed intestinal tract .
  • In the case of ulcerative colitis, it is also attempted to carry out a conservative therapy as long as possible. However, if there are complications, either parts of the intestine, sometimes even the entire colon (colon) , must be removed .
  • A diverticulum is always removed when it causes problems, which is not always the case.
  • Abscesses, fistulas and hemorrhoids are always surgically removed as the patients are usually free of complaints afterwards. In addition, however, anti-inflammatory drugs can be administered.

prophylaxis

Very many gastrointestinal diseases are to be avoided by a healthy lifestyle. Excessive alcohol intake, in particular, puts a heavy strain on the stomach and can lead to ulcers and cancer. Very greasy food and excessive coffee consumption promote the reflux of gastric acid into the esophagus and thus promote reflux oesophagitis. Thus, with the help of a healthy and balanced diet, quite a lot can be done for the intestine.

forecast

After the surgical removal, the chances of leading a symptom-free life are usually very good. As long as the cancer is detected early enough and removed before it could spread, chances are pretty good, too. The exception here is the gastric carcinoma, which has until today very poor prognoses.

Disease of the gastrointestinal tract (internal medicine)

All diseases of the gastrointestinal tract treated by the field of internal medicine can be found under the following link:

  • Gastrointestinal tract - Internal Medicine

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